Estrogens are a group of hormones
that play an important role in the
normal sexual and reproductive
development in women.
They are also sex hormones.
The woman's ovaries make most
estrogen hormones, although the
adrenal gland and fat cells also
make small amounts of the
hormones.
2. TOPIC: HYPER AND HYPO-ESTROGEN
ACTIVITY DRIVEN-PATHOLOGIES
Presented by: Sidra Fazal
Roll # UOC-BSZOL-F2020/039
BS Zoology
Session: 2020-2024
Subject: Endocrinology
Instructor Name: Dr. Syeda Nadia Ahmed
Department of Zoology
3. INTRODUCTION
Estrogens are a group of hormones
that play an important role in the
normal sexual and reproductive
development in women.
They are also sex hormones.
The woman's ovaries make most
estrogen hormones, although the
adrenal gland and fat cells also
make small amounts of the
hormones (Patel et al., 2018). Figure1: Estrogen
https://www.istockphoto.com/search/2/image-
film?phrase=estrogen
5. Estrone(E1):
This type of estrogen is
present in the body after
menopause.
The ovaries, placenta,
testicles, and fat tissue
produce estrone from
androstenedione or
androgens (Nichols, 2023).
Estradiol(E2):
Both males and females
produce estradiol, and it is
the most common type of
estrogen in females during
their reproductive years
(Nichols, 2023).
Estriol(E3):
Levels of estriol rise
during pregnancy, as it
helps the uterus grow
and prepares the body
for delivery. Estriol
levels peak just before
birth (Nichols, 2023).
Types of Estrogen
7. Factors that affect Levels of estrogen
•
• Some congenital conditions,
such as Turner’s syndrome
• high blood pressure
• diabetes
• Primary ovarian insufficiency
• Underactive pituitary gland
• Polycystic Ovary Syndrome
(PCOS)
• Tumors of the ovaries or
adrenal glands
• Pregnancy
• Puberty
• Menopause
• Older age
• Obesity
• Extreme dieting or anorexia
nervosa
• Strenuous exercise or training
• Certain medications,
including steroids, ampicillin,
estrogen-containing drugs
8. Estrone (E1) Estradiol (E2)
Before puberty
undetectable to
29pg/ml
undetectable to 20
pg/ml
During puberty 20–200 pg/ml
undetectable to 350
pg/ml
Before menopause 17–200 pg/ml 15–350 pg/ml
After menopause 7–40 pg/ml less than 10 pg/ml
Table 1: Normal Levels of Estrogen in Women
(Martin, 2023)
9. Estrone (E1) Estradiol (E2)
Before puberty
undetectable to 16
pg/ml
undetectable to 13
pg/ml
During puberty
undetectable to 60
pg/ml
undetectable to 40
pg/ml
Age 18 years and over 10–60 pg/ml 10–40 pg/ml
Table 2: Normal Levels of Estrogen in Men
(Martin, 2023)
10. Figure 2: Chart of Sex hormone production in humans
https://www.bigstockphoto.com/image-280014757
11. Estrogen imbalance and consequent diseases
❑ Both hyper and hypo
level of estrogen sets
off a diverse array of
diseases i.e.
Autoimmune
Metabolic
Neural
Gender-specific (Patel
et al., 2018)
Figure 3:Estrogen imbalance and
consequent diseases (Patel et al., 2018)
12. Hyper-estrogen activity-driven pathologies
1. Polycystic ovary syndrome (PCOS):
It is characterized by the endocrine disturbance, leading to cysts in the
ovaries.
Its symptoms include hirsutism, alopecia, amenorrhea, infertility,
hypertension, type 2 diabetes mellitus, depression etc (Patel et al.,
2018).
2. Endometriosis:
Endometriosis is a uterine anomaly where uterus tissues grow outside,
resulting in irregular periods, abdominal pain, chronic exhaustion, and
infertility (Patel et al., 2018).
13. 3. Autoimmune diseases:
Autoimmune diseases as systemic lupus erythromatosus (SLE) and multiple
sclerosis (MS) are also the resultants of estrogen overactivity (Patel et al.,
2018).
4. Gender specific effect:
High estrogen level leads to short stature (by early epiphyseal closure) in
both genders.
While it specifically causes hypogonadism and gynecomastia (the
proliferation of male breast glandular tissue) in males, and breast
hypertrophy in females (Patel et al., 2018).
14. 5. Cancers:
A number of cancers have been linked to ER expression in different tissues.
Such cancers include endometrial/ovarian cancer, caused by the
overexpression of estrogen in ovulatory follicles.
Gastric cancer, lungs cancer, hepatic cancer, and pituitary cancer are
other forms of cancers, resultant of high estrogen level.
Thyroid carcinoma and adenomatous goiter have been linked to
estrogens. The presence of ERα in human thyroid tumors and normal
thyroid glands has been reported (Patel et al., 2018).
16. Hypo-estrogen activity-driven pathologies
1. Osteoporosis:
Estrogen deficiency causes imbalance between bone absorption and
resorption that leads to osteoporosis, characterized by brittleness and
porosity of bones (Patel et al., 2018).
2. Alzheimer's disease:
The decrease in estrogen levels has been linked to Alzheimer's disease, a
kind of dementia marked by elevated production of amyloid beta (Aβ) and
hyperphosphorylation of tau protein, which causes hippocampus
degeneration.
Microtubules need tau protein to be stabilized, yet the post-translational
modification causes them to aggregate (Patel et al., 2018).
17. 3. Parkinson's disease:
Parkinson's disease is a neurodegenerative condition characterized by
tremor, bradykinesia (slow spontaneous movement), and discomfort.
It affects motor functions such as walking, balancing, and swallowing.
Parkinson's disease is caused by the degeneration of midbrain
substantianigra (Patel et al., 2018).
4. Schizophrenia:
Estrogen effect has been linked to schizophrenia, a neuropathology
associated with the dopaminergic system.
These diseases, which are often caused by low estrogen levels, manifest
as multiple illnesses (Patel et al., 2018).
18. 5. Arthralgia:
Arthralgia is characterized by joint pain, stiffness and functional disability.
Depleting estrogen level in elderly is responsible for this bone condition
(Patel et al., 2018).
6. Diabetes:
A declining level of estrogen influences blood glucose homeostasis, leading
to insulin resistance and obesity, and ultimately to diabetes and
cardiovascular disease risks.
In diabetics, estrogen deficiency increases the risk of renal pathology
through altered renal calcium absorption and overactivity of RAAS..
Low estrogen synthesis causes eunuchoid body and delayed epiphyseal
closure, which causes long stature (Patel et al., 2018).
19. 7. Preterm delivery:
Aromatase suppression, resulting in an estrogen shortage, and high blood
pressure cause preterm delivery due to eclampsia, a type of seizure during
pregnancy.
8. Gender-fluidity problems:
Gender-fluidity issues are caused by imbalance of estrogen.
Males with high estrogen levels can become more feminine, whereas
females with low estrogen levels can become more masculine due to
androgen dominance (Patel et al., 2018).
21. REFERENCES:
Patel, S., Homaei, A., Raju, A. B., & Meher, B. R. (2018). Estrogen: The
necessary evil for human health, and ways to tame it. Biomedicine &
Pharmacotherapy, 102, 403-411.
Nichols, H. (2023, November 20). Everything you need to know about
estrogen.
https://www.medicalnewstoday.com/articles/277177
Martin, L. (2023, January 31). What are the symptoms of high estrogen?
https://www.medicalnewstoday.com/articles/323280
